Daclatasvir plus asunaprevir effective, tolerable in older and younger genotype 1 HCV patients
Virological response and tolerance with daclatasvir plus asunaprevir therapy appear to be similar between older and younger patients with chronic genotype 1 hepatitis C virus (HCV) infection, a study has shown.
A total of 170 genotype 1 HCV-infected patients in the younger cohort (<75 years) and 139 in the older cohort (≥75 years) received dual therapy with daclatasvir plus asunaprevir for 24 weeks. Efficacy and safety outcomes—virological response and adverse events, respectively—were analysed according to age. The Invader assay facilitated identification of pretreatment resistance-associated variants (RAVs) at NS5A-L31 and NS5A-Y93.
At treatment completion, the sustained virological response (SVR) rate did not differ significantly between the older and younger cohorts (97.1 vs 92.4 percent, respectively). Of note was that all very elderly patients in the cohort (≥85 years; n=19) completed the 24 weeks of treatment and achieved SVR.
On multivariate regression analysis, the absence of prior simeprevir treatment significantly and independently predicted SVR (odds ratio, 56.6; p<0.001).
At a low population frequency (<25 percent), the SVR rate was similar between patients with RAVs and those with no detectable RAVs. The frequency of adverse events was also similar between younger and older patients.
The present data provide evidence of the safety and efficacy of the daclatasvir and asunaprevir dual therapy for older patients with chronic genotype 1 HCV infection, with virological response and tolerance comparable to that of younger patients.
“Even though RAVs were detected, virological response similar to that for patients with no detectable RAVs may still be expected for patients with RAVs as long as the population frequency is low,” researchers said.